Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;37(12):1966-1976.
doi: 10.1111/dme.14156. Epub 2019 Nov 12.

Distal technology interventions in people with diabetes: an umbrella review of multiple health outcomes

P Chakranon  1 , Y K Lai  2 , Y W Tang  3 , P Choudhary  4 , K Khunti  5 , S W H Lee  3   6   7
Affiliations

Distal technology interventions in people with diabetes: an umbrella review of multiple health outcomes

P Chakranon et al. Diabet Med. 2020 Dec.

Abstract

Aim: To summarize and evaluate the existing evidence on the effectiveness of distal technology with regard to multiple health outcomes in people with diabetes.

Methods: We searched PubMed, EMBASE and the Cochrane Database of Systematic Reviews from database inception to 31 August 2018 for systematic reviews and/or meta-analyses of studies that examined the impact of distal technology and reported any clinical or patient-related outcomes among people with type 1 or type 2 diabetes.

Results: The umbrella review identified 95 reviews, including 162 meta-analyses with 46 unique outcomes. Evidence from meta-analyses of randomized controlled studies supports the use of distal technology, especially telehealth and mHealth (healthcare delivered by mobile technology), in people with diabetes for improving HbA1c values by 2-4 mmol/mol (0.2-0.4%). For other health outcomes, such as changes in fasting plasma glucose levels, risk of diabetic ketoacidosis or frequency of severe hypoglycaemia, the evidence was weaker. No evidence was reported for most patient-reported outcomes including quality of life, self-efficacy and medication-taking. The evidence base was poor, with most studies rated as low to very low quality.

Conclusion: Distal technologies were associated with a modest improvement in glycaemic control, but it was unclear if they improved major clinical outcomes or were cost-effective in people with diabetes. More robust research to improve wider outcomes in people with diabetes is needed before such technologies can be recommended as part of routine care for any patient group.

PubMed Disclaimer

References

    1. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 2017; 128: 40-50.
    1. Gregg EW, Li Y, Wang J, Rios Burrows N, Ali MK, Rolka D et al. Changes in Diabetes-Related Complications in the United States, 1990-2010. N Engl J Med 2014; 370: 1514-1523.
    1. Kirkman MS, Rowan-Martin MT, Levin R, Fonseca VA, Schmittdiel JA, Herman WH et al. Determinants of Adherence to Diabetes Medications: Findings From a Large Pharmacy Claims Database. Diabetes Care 2015; 38: 604.
    1. Schechter CB, Walker EA. Improving Adherence to Diabetes Self-Management Recommendations. Diabetes Spectrum 2002; 15: 170.
    1. Kahn R, Anderson JE. Improving Diabetes Care: The Model for Health Care Reform. Diabetes Care 2009; 32: 1115.

Publication types

LinkOut - more resources